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Consistent with its known effects on the nitric oxide/cGMP pathway [see CLINICAL PHARMACOLOGY ], VIAGRA was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently is therefore contraindicated.

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Use caution when co-administering alpha-blockers with VIAGRA because of potential additive blood pressure-lowering effects. When VIAGRA is co-administered with an alpha-blocker, patients should be stable on alpha-blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at the lowest dose [see DOSAGE AND ADMINISTRATION , WARNINGS AND PRECAUTIONS , CLINICAL PHARMACOLOGY ].

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The radiobiology was characterized by in vivo irradiation of rat liver, dog liver, and dog brain. The animals were killed at varying intervals of time, and histological examinations were performed. Rats and dogs that were killed weeks to months after liver irradiation tended to have sharply demarcated lesions. Liver enzyme levels, measured serially in the dogs, did not give evidence of chronic inflammation.

The mean profiles of the change from baseline in standing systolic blood pressure in subjects treated with doxazosin in combination with 55 mg VIAGRA or matching placebo are shown in Figure 8.

VIAGRA has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers (mean maximum decrease of / mmHg), [see CLINICAL PHARMACOLOGY ]. While this normally would be expected to be of little consequence in most patients, prior to prescribing VIAGRA, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects, especially in combination with sexual activity.

There are no controlled clinical data on the safety or efficacy of Viagra in the following groups if prescribed, this should be done with caution.

VIAGRA can be taken with or without food. If you take VIAGRA after a high-fat meal (such as a cheeseburger and french fries), it may take a little longer to start working.

In many of the studies, of both fixed dose and titration designs, daily diaries were kept by patients. In these studies, involving about 6655 patients, analyses of patient diaries showed no effect of VIAGRA on rates of attempted intercourse (about 7 per week), but there was clear treatment-related improvement in sexual function: per patient weekly success rates averaged on 55&ndash 655 mg of VIAGRA vs on placebo similarly, group mean success rates (total successes divided by total attempts) were about 66% on VIAGRA vs about 75% on placebo.

Moreover, Sildenafil must not be taken with alcohol and nitrate drugs. As a result of medical interaction of sildenafil with ethanol or nitrates, there is a high probability of fainting because of low arterial pressure. In rare cases there might even be a fatal outcome.

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